2019 VBS Registration
Please use this form to register your child(ren) for Salem United Methodist Church's 2019 Vacation Bible School. If you are registering more than three children, please use an additional form(s). Should you have any questions, please do not hesitate contacting the church office at 302-436-8412.
Caregiver's First Name *
Your answer
Caregiver's Last Name *
Your answer
Caregiver's Contact Phone *
Your answer
Caregiver's Email Address *
Your answer
Caregiver's Home Address *
Your answer
Authorized #1 Person to Pick Up *
Your answer
Authorized #2 Person to Pick Up *
Your answer
Child #1 Name
Your answer
Child #1 Age
Your answer
Any medical conditions we need to be made aware of?
If you answered yes to a medical condition, please explain.
Your answer
Child #2 Name
Your answer
Child #2 Age
Your answer
Any medical conditions we need to be made aware of?
If you answered yes to a medical condition, please explain.
Your answer
Child #3 Name
Your answer
Child #3 Age
Your answer
Any medical conditions we need to be made aware of?
If you answered yes to a medical condition, please explain.
Your answer
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